Adherence to migraine treatment does not depend on the number of prescribed medications

Abstract

ObjectiveTo compare the adherence between monotherapy and politherapy in prophylactic migraine treatment.MethodFive hundred consecutive patients with migraine from a tertiary center were retrospectively studied as to the number of preventive medications prescribed during the first visit. Adherence, defined as returning for the next consultation after 4 to 6 weeks and following the prescribed regimens, were also evaluated and compared between patients.Results71.8% were women, and 6% of the patients did not receive any preventive medication, 11.4% received one drug, 22.2% two drugs, 41.4% three drugs, and 19% four drugs for the prevention of migraine. The overall adherence was 79.6%. Respectively, 73.7, 71.8, 82.6 and 86.3% of those who received the prescription of one, two, three and four drugs returned, complying with the treatment.ConclusionThere is no difference in adherence to monotherapy or politherapy (one to four drugs) for the prophylaxis of migraine.

Migraine Prophylaxis and Acute Treatment Patterns Among Commercially Insured Patients in the United States

“…Indeed, mean MPR at 6 months post‐index was 0.48 for antidepressants and 0.51 for antiepileptics and beta‐blockers; these MPRs are slightly higher than in our analysis and could reflect the shorter follow‐up period. A higher adherence to migraine medication (defined as a patient taking ≥80% of the prescribed medication) of 80% has been reported in a review of medical records from a specialist center in Brazil . These patients were treated and monitored by headache specialists, which may provide some explanation for the higher adherence rate than observed in other studies, although the higher adherence rate may also reflect geographical differences in the patient population and the management of migraine …”

Medication‐Overuse Headache: Protocols and Outcomes in 149 Consecutive Patients in a Tertiary Brazilian Headache Center

“…Based on our experience and what is available in the literature for Brazilian patients from tertiary centers, the use of preventive medications in migraineurs with high frequency headache or in chronic migraineurs is the rule …”

Treatment Adherence in Patients With Headache: A Systematic Review

“…34 A study assessing adherence in individuals with migraine through self-reported medication diary found 79.6% of the sample to be adherent to preventative medication on at least 80% of days and that adherence rates did not differ between patients with monotherapy and polytherapy treatment. 35 Similarly, Krymchantowski and Tavares utilized headache diaries as a measure of adherence and reported that 76.6% of the patients were adherent to preventative regimen with 4% being nonadherent prior to the 3-month evaluation and 19.4% not returning for the 3-month follow up. 36 A longitudinal study also examining adherence to β-blockers through headache medication diaries found that 94% (85/90) of patients had taken the prescribed β-blocker on at least 25 of 30 days over a 5-month period.…”